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New Drugs and Devices in the Pipeline for Heart Failure with Reduced Ejection Fraction Versus Heart Failure with Preserved Ejection Fraction

Abstract

Heart failure (HF) is a growing problem in the USA and other industrialized nations. HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF) each make up approximately half of the overall HF burden. Although a variety of medical and surgical therapies exist for the treatment of patients with HFrEF, morbidity and mortality remain high, and cardiac transplantation, considered the current gold standard for patients with HFrEF and severe symptoms, is reserved for relatively few eligible patients. Patients with HFpEF have more limited therapeutic options, because no medical therapy to date has been shown to improve survival in these patients. With the rising prevalence of HF and its increasing role in health care expenditure, there is a substantial need for new drug and device therapies for HFrEF and, in particular, HFpEF. This forms the topic of the current review.

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Abbreviations

BTT:

Bridge to transplant

DT:

Destination therapy

EF:

Ejection fraction

ERA:

Endothelin receptor antagonist

HF:

Heart failure

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

ICD:

Implantable cardioverter-defibrillator

CRT:

Cardiac resynchronization therapy

LV:

Left ventricle

LVAD:

Left ventricular assist device

MI:

Myocardial infarction

NO:

Nitric oxide

NYHA:

New York Heart Association

PA:

Pulmonary artery

PH:

Pulmonary hypertension

PDE-5:

Phosphodiesterase type 5

PAH:

Pulmonary arterial hypertension

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Amresh Raina has received compensation from the United Therapeutics Corporation for service as a consultant.

Manreet Kanwar declares that she has no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Raina, A., Kanwar, M. New Drugs and Devices in the Pipeline for Heart Failure with Reduced Ejection Fraction Versus Heart Failure with Preserved Ejection Fraction. Curr Heart Fail Rep 11, 374–381 (2014). https://doi.org/10.1007/s11897-014-0222-8

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Keywords

  • Heart failure
  • Device therapy
  • Drug therapy
  • LVAD
  • Mechanical circulatory support